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<p><b>OBJECTIVE</b>To compare the surgical effect of three-dimensional (3D) versus 2D laparoscopic surgery in ureter lithotomy.</p><p><b>METHODS</b>From January 2014 to 2015 May, 45 patients with ureteral calculi were randomly allocated into 2 groups to undergo ureter lithotomy under 3D laparoscopy (25 cases) and 2D laparoscopy (20 cases). The time used for each surgical process (including the exposure, D-J tube discharge, suture and other surgical procedures) was recorded and compared between the two groups.</p><p><b>RESULTS</b>The operation was completed smoothly in all the 45 patients. In this cohort, the wound drainage tube was removed in a mean of 3.0mnplus;0.8 days after the operation, the catheter was removed after a week, and the double J tube was removed at 1 month. Follow-up intravenous pyelography at 3 months after the operation reveal ureteral stricture in none of the cases. Comparison of the surgical data showed that the time used in each surgical process was significantly shorter in the 3D group than in the 2D group (P<0.05). 3D laparoscopic surgery allowed more precise operation by providing a good sense of depth as in an open surgery to reduce the operation time.</p><p><b>CONCLUSIONS</b>As a minimally invasive surgical technique, 3D laparoscopic surgery facilitates more precise and easier operation compared with 2D laparoscopy in ureter lithotomy.</p>
Subject(s)
Humans , Imaging, Three-Dimensional , Kidney Pelvis , Laparoscopy , Methods , Operative Time , Retroperitoneal Space , Ureter , Ureteral Calculi , General SurgeryABSTRACT
Objective To summarize the safety and efficacy of Sunitinib in the treatment of metastatic renal clear cell carcinoma. Methods Fifteen patients with clear cell metastatic RCC were treated with Sunitinib,with 11 males and 4 females,aged from 26 to 74 years with median age of 55 years.Thirteen cases of 15 were T3 to T4 stage,and 8 cases underwent radical nephrectomy,while 5 other cases underwent renal biopsy with the pathological diagnosis of renal cancer.The other two cases (one man and one woman)with the solitary kidney renal cell carcinoma ( stage T1a) and renal insufficiency,were diagnosed as metastatic renal cell carcinoma by biopsy.Sunitinib monotherapy was administered by the regimen of 6 weeks per cycle with daily oral Sunitinib 4 weeks,followed by 2 weeks off ( from 1 - 10 cycles).Response was evaluated by RECIST.Renal tumor was 9.52 ± 3.3 cm in diameter at baseline,and the assessment of metastases included retroperitoneal lymph nodes (6 cases),mediastinal lymph nodes (3 cases),brain (2 cases),lung (6 cases),bone (2 cases) and liver (2 cases).Karnofsky score,tumor changes,adverse events and the survival of each patient was assessed and recorded. Results The follow-up duration was from 1.5 - 15months,with median follow-up of 6 months,and tumor response was evaluated by RECIST.Seven of 15 patients (46.7％) treated with Sunitinib achieved partial responses (PR),7 patients (46.7％) demonstrated stable disease (SD),and 1 patient (6.7％) developed progressive disease (PD) during the follow-up.Objective Response Rate (ORR) was 46.7％,PR + SD was 93.3％,6 months PFS was 93.3％,and median PFS was 12 months,respectively.Renal tumor was 8.7 ± 4.0 cm in diameter after therapy.Two PR patients with the obvious effectiveness had experienced progressed hypertension,and one cases with hypertension that could be controlled below 140/90 mm Hg ( 1 mm Hg =0.133 kPa) by a single drug before treatment,showed increased blood pressure ( ＞ 160/105 mm Hg) following the second cycles treatment,who were administered increased dosage and combination therapy.The other case without history of hypertension,showed high blood pressure ( ＞ 150/100 mm Hg) in the third cycle,and could be controlled well by antihypertensive drugs.Fortunately,the tumor of these two cases reduced obviously by more than 50％. 1/2 adverse reactions of 12 cases:yellowing of the skin and yellow sweat ( 12 cases,80％ ),fatigue ( 12 cases,80％ ),4 cases of hypothyroidism (26.7％),bilirubin and triglyceride levels elevated in 7case (46.7％); Four cases showed 3/4 degree adverse events with the emergence of gastrointestinal bleeding in one case secondary to platelets reduction (6.7％).Three cases (20％) showed serious fatigue,nausea,vomiting and severe hand-foot skin reaction. Conclusions Sunitinib is recommended for the treatment of metastatic renal clear cell carcinoma with good efficacy and safety.
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0.05).There were significant difference but 50mA image quality betweer the rest of the three groups(P
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Objective To explore the clinical application for various radiographic body in patients with osteoarthritis of the knee.Methods The exact data of various image body for the joint cavity of knee and patella-femur was got by making use of radiographic body for double knee joint weight-bear AP & LAT and flexuosity weight-bear PA,flexuosity weight-bear axial position for double patella and weight-bear double total length lower extremities.Results Data of the knee joint exterior angle for 75 patients with osteoarthritis of the knee weight-bear AP and keep down AP was measure.Software of statistics for partnership t test was employed and that P
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Objective To explore the photographic parameter for CR image splicing of double total length lower extremities and the evaluation of clinical application. Methods The suitable X-ray exposure conditions for full-leg digital radiograph was chosen according to the application of FCR-5000 CR imaging system and the exposure conditions of CR in osseous system. Results Optimal tube voltage and milliamp-second of parameters for the full-length leg projection was acquired in terms of the distribution of spatial resolution under different parameters of exposure. Conclusion The exposure parameter of CR in full-leg image stitching should be based on the characteristics of CR imaging system and the results of experiment. It is important to choose the most appropriate exposure parameters to ensure image quality and reduce radiation dose on patients to provide veracious image data for clinical application with osteoarthritis of the knee.